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La sclérose en plaques (SEP) est caractérisée par des infiltrations périvasculaires de cellules immunitaires et par de la démyélinisation au sein du système nerveux central (SNC). Ces deux paramètres de la maladie sont associés à la fragilisation de la barrière hémato-encéphalique (BHE). En ce sens, le recrutement des cellules présentatrices d’antigène (CPA) myéloïdes, telles que les monocytes, les macrophages et les cellules dendritiques, dans le SNC à travers la BHE, est une étape cruciale dans l’initiation et la persistance de l’inflammation cérébrale. Nerve injury-induced protein (Ninjurin)-1 est une nouvelle molécule d’adhérence qui médie une interaction de type homophilique et dont l’expression sur l’endothélium vasculaire de la BHE humaine fut identifiée grâce à une analyse protéomique des protéines associées à la BHE. Les résultats présentés dans ce mémoire montrent que l’expression de Ninjurin-1 augmente dans un contexte inflammatoire dans les cultures primaires de cellules endothéliales de la BHE (CE-BHE) et sur les CPA myéloïdes humaines ex vivo et générées in vitro. De plus, les CPA infiltrantes retrouvées dans les lésions cérébrales de patients atteints de SEP et dans le SNC des souris atteintes d’encéphalomyélite autoimmune expérimentale (EAE), le modèle murin de la SEP, expriment de hauts niveaux de Ninjurin-1. À l’aide du modèle in vitro de la BHE, la neutralisation de Ninjurin-1 restreint spécifiquement la migration des monocytes à travers les CE-BHE sans affecter le recrutement des lymphocytes, ni la perméabilité des CE-BHE. Enfin, les souris atteintes d’EAE et traitées avec un peptide bloquant dirigé contre Ninjurin-1 présentent une maladie moins sévère ainsi qu’une diminution des CPA infiltrant le SNC et ce comparé au groupe contrôle. Ces résultats suggèrent que Ninjurin-1 est une molécule d’adhérence de la BHE impliquée dans le recrutement de CPA myéloïdes au sein du SNC et qu’elle peut être considérée comme une cible thérapeutique potentielle en SEP. / Multiple Sclerosis (MS) is characterized by perivascular infiltrations of immune cells and by demyelination in the central nervous system (CNS). These two hallmarks of the disease are associated with the disruption of the blood-brain barrier (BBB). The recruitment of monocytes, macrophages and dendritic cells, the so-called myeloid antigen-presenting cells (APCs), in the CNS through the BBB is thought to play a crucial role in the initiation and the persistence of the disease. Therefore the identification of the molecular mechanisms involved in the migration of myeloid APCs into the CNS is considered a valid therapeutic option in MS. Nerve injury-induced protein (Ninjurin)-1, a novel adhesion molecule that mediates homophilic binding, was found to be expressed in the vascular endothelium of the BBB following a proteomic screen of human BBB-associated proteins. Ninjurin-1’s expression increases during an inflammatory context in primary cultures of endothelial cells of the BBB (BBB-ECs) and on ex vivo and in vitro generated myeloid APCs. In addition, infiltrating APCs in human MS lesions and in the CNS of the murine model of MS, the mice affected with experimental autoimmune encephalomyelitis (EAE), express high levels of Ninjurin-1. Using an experimental model of the BBB, the neutralization of Ninjurin-1 specifically restricts the migration of monocytes across the BBB-ECs without affecting the recruitment of lymphocytes or the permeability of the BBB-ECs. Finally, EAE mice treated with a Ninjurin-1 blocking peptide have reduced disease severity and a reduced infiltration of myeloid APCs in the CNS, as compared to the control group. Our results show that Ninjurin-1 is an adhesion molecule of the BBB involved in the recruitment of myeloid APCs to the CNS and is also a potential therapeutic target to dampen CNS inflammatory processes, as occurs in MS.

La sclérose en plaques (SEP) est une maladie inflammatoire du système nerveux central (SNC) caractérisée par une infiltration périvasculaire de cellules mononucléaires, telles que les lymphocytes T CD4+ et CD8+, les lymphocytes B ainsi que les cellules myéloïdes qui comprend les monocytes, les macrophages et les cellules dendritiques (DCs). Ce phénomène d’infiltration est dû à une fragilisation de la barrière hémato-encéphalique (BHE). L’entrée des cellules immunitaires au SNC va mener à la destruction de la gaine de myéline et donc à l’apparition de plaques de démyélinisation. Ainsi, nous avons émis l’hypothèse que la migration des divers sous-types de cellules immunitaires du sang périphérique à travers la BHE est contrôlée par des mécanismes moléculaires distincts et spécifiques à chaque type cellulaire. Afin de répondre à cette hypothèse, quatre différentes études ont été mises sur pieds. En premier lieu, nous démontrons un effet bénéfique des statines sur la BHE en SEP, en diminuant la migration des lymphocytes T et des monocytes, et en diminuant la diffusion de marqueurs moléculaire soluble. Ce phénomène s’opère via la suppression du processus d’isoprenylation, et en empêchant probablement la contraction des cellules endothéliales de la BHE. De plus, nous démontrons que les monocytes qui migrent au SNC en condition inflammé sont en mesures de se différencier en DCs et d’induire une réponse inflammatoire de la part des lymphocytes T CD4+. La migration des monocytes à travers la BHE est contrôlée par une nouvelle molécule d’adhérence nommée Ninjurin-1. Le blocage de Ninjurin-1 conduit à une inhibition spécifique de la migration des monocytes in vitro, ainsi qu’à une amélioration des signes cliniques du modèle animal de la SEP, soit l’encéphalomyélite auto-immune expérimentale (EAE). Finalement, nous démontrons que la migration des lymphocytes T CD8+ au SNC s’effectue via l’intégrine alpha-4. De plus, la majorité des lymphocytes T CD8+ que l’on retrouve dans le liquide céphalo-rachidien de patients SEP, dans le SNC de souris EAE ainsi que dans le SNC de souris infectée au virus de l’hépatite murine portent un phénotype effecteur mémoire. Ces données pourraient expliquer l’émergence de leucoencéphalopathie multifocale progressive observée chez certains patients SEP traités au natalizumab, un anticorps dirigé contre l’intégrine alpha-4. En conclusion, notre étude a permis de démontrer l’importance des monocytes provenant de la périphérie dans le processus inflammatoire prenant part au SNC en SEP. L’inhibition d’entrée de ces cellules pourrait s’avérer bénéfique en SEP tout en permettant l’immuno-surveillance du cerveau, ce que l’anti-alpha-4 intégrine ne permet pas. Les statines pourraient s’avérer une autre option intéressante puisqu’elles agissent sur les processus inflammatoires impliqués dans la SEP. / Multiple sclerosis (MS) is an immune-mediated disorder of the central nervous system (CNS) characterized by multifocal areas of leukocyte infiltration and demyelination associated with a breakdown of the blood-brain barrier (BBB). Typically, demyelination is centered around perivascular accumulation of CD4+ and CD8+ T lymphocytes, monocytes, macrophages and dendritic cells (DCs) that arise from migration of peripheral blood immune cells across the CNS microvascular endothelium. We have thus suggested that the migration across the BBB of immune cells subsets from the blood is controlled by molecular mechanism specific for each cell type. To answer this hypothesize, we have performed four different studies. We first show a beneficial effect of statins on the BBB, restricting the migration of lymphocytes and monocytes as well as the diffusion of soluble molecular tracers. This phenomenon is mediated through abrogation of isoprenylation processes that is probably inhibiting the ability of endothelial cells of the BBB to contract. We also show that CD14+ monocytes migrate across the inflamed human blood BBB and differentiate into DCs in response to BBB-secreted TGF-beta and GM-CSF. These DCs then promote the proliferation and expansion of inflammatory CD4+ T lymphocytes. We demonstrate that the migration of monocytes is controlled by a new adhesion molecule called Ninjurin-1. Ninjurin-1 neutralization specifically abrogated the adhesion and migration of human monocytes across endothelial cells of the BBB, without affecting lymphocyte recruitment. Moreover, Ninjurin-1 blockade reduced clinical disease activity and histopathological indices of experimental allergic encephalomyelitis (EAE). Finally we show that migration of CD8+ T lymphocytes across BBB is dependent on alpha-4 integrin. Also, the majority of CD8+ T lymphocytes found in the cerebrospinal fluid of MS patients, and in the CNS of EAE mice as well as the CNS of mouse infected with hepatitis virus are showing an effector memory phenotype. These data could explain the numerous cases of progressive multifocal leukoencephalopathy seen in natalizumab treated MS patients. In conclusion, our study unveils an important role of peripheral monocytes in MS. The inhibition of migration of these cells to the CNS could be a beneficial therapy since it would allow immune surveillance of the brain. The statins could also be a very interesting option since these molecules would reduce the inflammatory processes involved in MS.

La sclérose en plaques (SEP) est caractérisée par des infiltrations périvasculaires de cellules immunitaires et par de la démyélinisation au sein du système nerveux central (SNC). Ces deux paramètres de la maladie sont associés à la fragilisation de la barrière hémato-encéphalique (BHE). En ce sens, le recrutement des cellules présentatrices d’antigène (CPA) myéloïdes, telles que les monocytes, les macrophages et les cellules dendritiques, dans le SNC à travers la BHE, est une étape cruciale dans l’initiation et la persistance de l’inflammation cérébrale. Nerve injury-induced protein (Ninjurin)-1 est une nouvelle molécule d’adhérence qui médie une interaction de type homophilique et dont l’expression sur l’endothélium vasculaire de la BHE humaine fut identifiée grâce à une analyse protéomique des protéines associées à la BHE. Les résultats présentés dans ce mémoire montrent que l’expression de Ninjurin-1 augmente dans un contexte inflammatoire dans les cultures primaires de cellules endothéliales de la BHE (CE-BHE) et sur les CPA myéloïdes humaines ex vivo et générées in vitro. De plus, les CPA infiltrantes retrouvées dans les lésions cérébrales de patients atteints de SEP et dans le SNC des souris atteintes d’encéphalomyélite autoimmune expérimentale (EAE), le modèle murin de la SEP, expriment de hauts niveaux de Ninjurin-1. À l’aide du modèle in vitro de la BHE, la neutralisation de Ninjurin-1 restreint spécifiquement la migration des monocytes à travers les CE-BHE sans affecter le recrutement des lymphocytes, ni la perméabilité des CE-BHE. Enfin, les souris atteintes d’EAE et traitées avec un peptide bloquant dirigé contre Ninjurin-1 présentent une maladie moins sévère ainsi qu’une diminution des CPA infiltrant le SNC et ce comparé au groupe contrôle. Ces résultats suggèrent que Ninjurin-1 est une molécule d’adhérence de la BHE impliquée dans le recrutement de CPA myéloïdes au sein du SNC et qu’elle peut être considérée comme une cible thérapeutique potentielle en SEP. / Multiple Sclerosis (MS) is characterized by perivascular infiltrations of immune cells and by demyelination in the central nervous system (CNS). These two hallmarks of the disease are associated with the disruption of the blood-brain barrier (BBB). The recruitment of monocytes, macrophages and dendritic cells, the so-called myeloid antigen-presenting cells (APCs), in the CNS through the BBB is thought to play a crucial role in the initiation and the persistence of the disease. Therefore the identification of the molecular mechanisms involved in the migration of myeloid APCs into the CNS is considered a valid therapeutic option in MS. Nerve injury-induced protein (Ninjurin)-1, a novel adhesion molecule that mediates homophilic binding, was found to be expressed in the vascular endothelium of the BBB following a proteomic screen of human BBB-associated proteins. Ninjurin-1’s expression increases during an inflammatory context in primary cultures of endothelial cells of the BBB (BBB-ECs) and on ex vivo and in vitro generated myeloid APCs. In addition, infiltrating APCs in human MS lesions and in the CNS of the murine model of MS, the mice affected with experimental autoimmune encephalomyelitis (EAE), express high levels of Ninjurin-1. Using an experimental model of the BBB, the neutralization of Ninjurin-1 specifically restricts the migration of monocytes across the BBB-ECs without affecting the recruitment of lymphocytes or the permeability of the BBB-ECs. Finally, EAE mice treated with a Ninjurin-1 blocking peptide have reduced disease severity and a reduced infiltration of myeloid APCs in the CNS, as compared to the control group. Our results show that Ninjurin-1 is an adhesion molecule of the BBB involved in the recruitment of myeloid APCs to the CNS and is also a potential therapeutic target to dampen CNS inflammatory processes, as occurs in MS.

La sclérose en plaques (SEP) est une maladie inflammatoire du système nerveux central (SNC) caractérisée par une infiltration périvasculaire de cellules mononucléaires, telles que les lymphocytes T CD4+ et CD8+, les lymphocytes B ainsi que les cellules myéloïdes qui comprend les monocytes, les macrophages et les cellules dendritiques (DCs). Ce phénomène d’infiltration est dû à une fragilisation de la barrière hémato-encéphalique (BHE). L’entrée des cellules immunitaires au SNC va mener à la destruction de la gaine de myéline et donc à l’apparition de plaques de démyélinisation. Ainsi, nous avons émis l’hypothèse que la migration des divers sous-types de cellules immunitaires du sang périphérique à travers la BHE est contrôlée par des mécanismes moléculaires distincts et spécifiques à chaque type cellulaire. Afin de répondre à cette hypothèse, quatre différentes études ont été mises sur pieds. En premier lieu, nous démontrons un effet bénéfique des statines sur la BHE en SEP, en diminuant la migration des lymphocytes T et des monocytes, et en diminuant la diffusion de marqueurs moléculaire soluble. Ce phénomène s’opère via la suppression du processus d’isoprenylation, et en empêchant probablement la contraction des cellules endothéliales de la BHE. De plus, nous démontrons que les monocytes qui migrent au SNC en condition inflammé sont en mesures de se différencier en DCs et d’induire une réponse inflammatoire de la part des lymphocytes T CD4+. La migration des monocytes à travers la BHE est contrôlée par une nouvelle molécule d’adhérence nommée Ninjurin-1. Le blocage de Ninjurin-1 conduit à une inhibition spécifique de la migration des monocytes in vitro, ainsi qu’à une amélioration des signes cliniques du modèle animal de la SEP, soit l’encéphalomyélite auto-immune expérimentale (EAE). Finalement, nous démontrons que la migration des lymphocytes T CD8+ au SNC s’effectue via l’intégrine alpha-4. De plus, la majorité des lymphocytes T CD8+ que l’on retrouve dans le liquide céphalo-rachidien de patients SEP, dans le SNC de souris EAE ainsi que dans le SNC de souris infectée au virus de l’hépatite murine portent un phénotype effecteur mémoire. Ces données pourraient expliquer l’émergence de leucoencéphalopathie multifocale progressive observée chez certains patients SEP traités au natalizumab, un anticorps dirigé contre l’intégrine alpha-4. En conclusion, notre étude a permis de démontrer l’importance des monocytes provenant de la périphérie dans le processus inflammatoire prenant part au SNC en SEP. L’inhibition d’entrée de ces cellules pourrait s’avérer bénéfique en SEP tout en permettant l’immuno-surveillance du cerveau, ce que l’anti-alpha-4 intégrine ne permet pas. Les statines pourraient s’avérer une autre option intéressante puisqu’elles agissent sur les processus inflammatoires impliqués dans la SEP. / Multiple sclerosis (MS) is an immune-mediated disorder of the central nervous system (CNS) characterized by multifocal areas of leukocyte infiltration and demyelination associated with a breakdown of the blood-brain barrier (BBB). Typically, demyelination is centered around perivascular accumulation of CD4+ and CD8+ T lymphocytes, monocytes, macrophages and dendritic cells (DCs) that arise from migration of peripheral blood immune cells across the CNS microvascular endothelium. We have thus suggested that the migration across the BBB of immune cells subsets from the blood is controlled by molecular mechanism specific for each cell type. To answer this hypothesize, we have performed four different studies. We first show a beneficial effect of statins on the BBB, restricting the migration of lymphocytes and monocytes as well as the diffusion of soluble molecular tracers. This phenomenon is mediated through abrogation of isoprenylation processes that is probably inhibiting the ability of endothelial cells of the BBB to contract. We also show that CD14+ monocytes migrate across the inflamed human blood BBB and differentiate into DCs in response to BBB-secreted TGF-beta and GM-CSF. These DCs then promote the proliferation and expansion of inflammatory CD4+ T lymphocytes. We demonstrate that the migration of monocytes is controlled by a new adhesion molecule called Ninjurin-1. Ninjurin-1 neutralization specifically abrogated the adhesion and migration of human monocytes across endothelial cells of the BBB, without affecting lymphocyte recruitment. Moreover, Ninjurin-1 blockade reduced clinical disease activity and histopathological indices of experimental allergic encephalomyelitis (EAE). Finally we show that migration of CD8+ T lymphocytes across BBB is dependent on alpha-4 integrin. Also, the majority of CD8+ T lymphocytes found in the cerebrospinal fluid of MS patients, and in the CNS of EAE mice as well as the CNS of mouse infected with hepatitis virus are showing an effector memory phenotype. These data could explain the numerous cases of progressive multifocal leukoencephalopathy seen in natalizumab treated MS patients. In conclusion, our study unveils an important role of peripheral monocytes in MS. The inhibition of migration of these cells to the CNS could be a beneficial therapy since it would allow immune surveillance of the brain. The statins could also be a very interesting option since these molecules would reduce the inflammatory processes involved in MS.

Made available in DSpace on 2016-01-26T12:51:29Z (GMT). No. of bitstreams: 1 carlarenatagraca_dissert.pdf: 933158 bytes, checksum: fdfd445f7f2238bec496e0064ddfd5bc (MD5) Previous issue date: 2011-07-26 / Leprosy is a chronic infectious disease caused by Mycobacterium leprae (M. leprae), an obligate intracellular acid-fast bacillus, which affects the skin and peripheral nervous system. The diseases expression results from the interaction between the bacillus and the immune system; most infected subjects develop effective immune response against M. leprae, without disease; others exhibit a spectrum of clinical manifestations closely linked to the pattern of host immune response to pathogen. Among the host defense mechanisms are immunoregulatory cytokines with activities represented by specific populations of Th1 and Th2 lymphocytes and the production of reactive oxygen species (ROS), which are key elements for bacterial destruction intramacrofágica. In this context, several genomic regions have been implicated in susceptibility and severity in genetically controlled leprosy. The glutathione Stransferase are enzymes that eliminate reactive oxygen species, are the most studied genes: GSTM1 and GSTT1. The NINJURIN1 is a cell adhesion molecule that provides suitable substrates for repair of Schwann cells after peripheral nerve injury. The single nucleotide polymorphism NINJ1, encoded by the protein NINJURIN1, is the result of a transversion to adenine nucleotide polymorphic cytokine (AC), responsible in an amino acid exchange of asparagine for alanine at position 110 of the protein (asp110ala). Objectives. 1) Investigate if the presence of polymorphism in the GSTT1 and GSTM1 genes could affect the course of leprosy; 2) Investigate if the presence of polymorphism in the NINJ1 gene could be relevant for neural impairment. Material and Methods. A cohort of 218 leprosy patients (patients) and 244 subjects without leprosy (controls) was studied. The genomic DNA was obtained from peripheral blood, GSTT1 and GSTM1 polymorphism screening was performed using polymerase chain xi Abstract v reaction and NINJ1 gene analysis was performed using the technique of restriction fragment length polymorphism (PCR-RFLP) using the enzyme Hae III. The genotype and allele frequency were measured by Chi-square and logistic regression models with or without correction for age and gender. Results. The frequency of the GSTT1/GSTM1 null genotypes was significantly higher in controls when compared to patients (P = 0.01). The GSTT1 genotype frequency was significantly increased in patients when compared to controls (P=0.01). The frequency of the NINJ1 asp110ala was significantly increased in patients with nerve impairment (p = 0.0198). Also, patients with the CC (ala/ala) allele had a higher risk of developing disability when compared the allele AA (asp/asp) (p = 0.0143). Conclusion. The results demonstrated: (1) there is an association of GSTT1 positive genotype for development of leprosy disease. The data found suggested that the absence of GSTs, with a consequent permanence of intracellular ROS, can contribute to M. leprae destruction and, therefore, reduce the disease risk; (2) polymorphism in NINJ1 gene offers less nerve protection in leprosy patients. This finding indicates that NINJURIN1 is an important adhesion molecule and can be a potential therapeutic tool in many diseases. / A hanseníase é uma doença infecciosa crônica causada pelo bacilo álcool-ácido resistente Mycobacterium leprae (M. leprae), patógeno intracelular obrigatório, que afeta a pele e o sistema nervoso periférico. A expressão dessa doença resulta da interação entre o bacilo e o sistema imunológico; a maioria das pessoas infectadas desenvolve resposta imune eficaz contra M. leprae, sem sintomas da doença; outras exibem um espectro de manifestações clínicas ligado ao padrão da resposta imunológica do hospedeiro ao patógeno. Entre os mecanismos de defesa do hospedeiro estão as citocinas com atividades imunorreguladoras específicas representadas pelas populações de linfócitos Th1 e Th2 e a produção de espécies reativas de oxigênios (ROS), que são elementos fundamentais para destruição bacilar intramacrofágica. Nesse contexto, inúmeras regiões genômicas têm sido implicadas na suscetibilidade e na severidade geneticamente controlada à hanseníase. Os Glutatião S-transferase são enzimas que eliminam as espécies reativas de oxigênio, os genes mais estudados são: GSTT1 e GSTM1. O NINJURIN1 é uma molécula de adesão celular que fornece substratos apropriados para reparação das células de Schwann após lesão no nervo periférico. O polimorfismo de nucleotídeo único NINJ1 codificado pela proteína NINJURIN1, é resultado de uma transversão polimórfica do nucleotídeo adenina para citocina (AC), responsável pela troca de um aminoácido asparagina para alanina na posição 110 da proteína (asp110ala). Objetivos. 1) avaliar os polimorfismos dos genes GSTT1 e GSTM1 na modulação da suscetibilidade genética à hanseníase e/ou à evolução dessa doença em seus pólos maligno ou benigno; 2) investigar a correlação entre o polimorfismo de nucleotídeo único NINJURIN1 e o grau de comprometimento do nervo periférico. Materiais e Métodos. A amostra foi composta de 218 pacientes xi Resumo com hanseníase (pacientes) e 244 indivíduos sem hanseníase (controles). O DNA genômico foi obtido de sangue periférico, a análise dos polimorfismos GSTT1 e GSTM1 foi realizada utilizando a técnica de reação em cadeia da polimerase (PCR) e a análise do gene NINJ1 foi realizada através da técnica de polimorfismo de comprimento de fragmento de restrição (PCR-RFLP), utilizando a enzima HAE III. A frequência de genótipos e alelos foi analisada pelo teste do qui-quadrado e por modelos de regressão logística com ou sem correção para idade e sexo. Resultados. A frequência dos genótipos nulos GSTT1/GSTM1 foi significativamente maior nos controles que nos pacientes (P = 0,01). A frequência do genótipo GSTT1 foi significativamente maior nos pacientes em relação aos controles (P = 0,01). A frequência do polimorfismo NINJ1 asp110ala foi significativamente maior em pacientes com comprometimento do nervo (p = 0, 0198). Além disso, pacientes com o alelo CC (ala / ala) apresentaram risco maior de desenvolver lesão no nervo quando comparado ao alelo AA (asp / asp) (p = 0,0143). Conclusão. Os resultados demonstraram: (1) há associação do genótipo GSTT1 positivo para o desenvolvimento da hanseníase. Os achados sugerem que a ausência de GSTs, com consequente permanência de ROS intracelular, pode contribuir para a eliminação do M. leprae e, dessa forma, reduzir o risco da doença; (2) o polimorfismo no gene NINJ1 oferece menos proteção ao nervo na hanseníase. Esse achado indica que a NINJURIN1 é uma molécula de adesão importante e pode ser uma potencial ferramenta terapêutica em muitas doenças.